Ibuprofen versus other non-steroidal anti-in ammatory drugs: use in general practice and patient perception

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Ibuprofen versus other non-steroidal anti-in ammatory drugs: use in general practice and patient perception"

Transcription

1 Aliment Pharmacol Ther 2000; 14: 187±191. Ibuprofen versus other non-steroidal anti-in ammatory drugs: use in general practice and patient perception C. J. HAWKEY 1,D.J.E.CULLEN 1,9,G.PEARSON 1,S.HOLMES 2,M.DOHERTY 3,J.V.WILSON 4, P. GARRUD 6,S.GARNER 7, A. MAYNARD 8 &R.F.A.LOGAN 5 1 Division of Gastroenterology, 6 Department of Behavioural Sciences, 7 Pharmacy Department, University Hospital; 2 Belvoir Health Group General Practice; 3 Division of Rheumatology, City Hospital; 4 Family Health Services Authority; 5 Department of Public Health Medicine & Epidemiology, University of Nottingham, Nottingham, UK; 8 Centre for Health Economics, York, UK; and 9 Freemantle Hospital, Western Australia Accepted for publication 18 October 1999 SUMMARY Objective: To investigate whether ibuprofen was as well-regarded by patients as other non-steroidal antiin ammatory drugs (NSAIDs). Design: Questionnaire sent to 1137 consecutive recipients of an NSAID prescription from 21 doctors in six general practices with computerized records. Patient responses were subsequently linked to data held on the practice records. Setting: General practices in and around Nottingham, selected to re ect local variations in number of partners, list size, geographical location, deprivation, prescribing burden and prescribing rate. Subjects: Unselected patients receiving NSAIDs prescribed for all indications for use. Main outcome measures: Effectiveness of ibuprofen and other NSAIDs, possible drug related adverse events, patients' overall satisfaction with ibuprofen and other NSAIDs, factors associated with choice of ibuprofen, drug costs of ibuprofen and other NSAIDs. Results: The main NSAIDs used were ibuprofen, diclofenac and naproxen. Ibuprofen use ranged from 1.0% of prescriptions in one practice to 69.1% in another. Although ibuprofen was generally prescribed in low doses, it was perceived by patients as being as effective as the other NSAIDs used, even after allowing for severity of the pre-treatment condition. Overall, 50.5% of patients rated their NSAID the best treatment they had received for their condition with no differences between individual drugs. Conclusions: Ibuprofen is as highly regarded as other NSAIDs when used in similar circumstances. Switching patients to ibuprofen may be a realistic way of reducing nancial and medical costs associated with NSAIDs. INTRODUCTION Non-steroidal anti-in ammatory drugs (NSAIDs) are associated with a high incidence of side-effects, particularly gastrointestinal side-effects. 1±3 Epidemiological studies suggest that some NSAIDs are less likely to cause gastrointestinal complications than others. A systematic Correspondence to: Professor C. J. Hawkey, Division of Gastroenterology, University Hospital, Nottingham, NG7 2UH, UK. review of studies that examined the relative risks of gastrointestinal complications associated with different NSAIDs found ibuprofen to be the least toxic NSAID. 4 Since ibuprofen is also cheaper than other NSAIDs, switching patients from more toxic NSAIDs to ibuprofen could achieve both nancial and medical savings. However, ibuprofen's lower toxicity may due to the fact that it is used in relatively low effective doses in clinical practice and it is not known how ibuprofen is perceived by patients in comparison to other NSAIDs when used for unselected indications in general practice. Ó 2000 Blackwell Science Ltd 187

2 188 C. J. HAWKEY et al. We therefore conducted a study using scrutiny of general practice records and a postal questionnaire of all patients receiving NSAIDs in six general practices in Nottingham to investigate patient perception of the effectiveness and tolerability of ibuprofen and other NSAIDs and overall patient satisfaction with treatment. METHODS As described in the accompanying paper, a research assistant visited six Nottingham General Practices every week over a 4-month period and identi ed recipients of an NSAID. Each of these patients was sent a questionnaire concerning the effectiveness, tolerability and sideeffects of their current NSAID. Other information (indication for use, no. of other medications, age, sex, history of ulcer disease and co-prescription of anti ulcer drugs) was extracted from the patient notes. For comparative purposes, drug doses were converted into de ned daily doses. 5 The de ned daily dose for ibuprofen is 800 mg, for diclofenac 75 mg and for naproxen 500 mg. Compliance (percentage of intended dose taken) was calculated from patient questionnaire replies and the general practitioner record, assuming that consumption started on the day following the prescription. Drug costs were calculated based on the data for the average doses, compliance and frequency of individual drug usage recorded during the study and minimum British National Formulary costs. The costs of individual NSAIDs used by less than 1% of patients was assumed to be a weighted average of the cost of all other NSAIDs. Statistical methods Descriptive statistics were computed using the SPSS-X statistical package. The v 2 -test (with Yates' continuity correction) was used to compare proportions. With comparisons for ordered categorical variables such as age, the v 2 -test for trend was used. In order to identify variables associated with speci c NSAID choice, drug effectiveness, drug adverse drug reactions (ADRs) and overall patient satisfaction, a number of potential determining variables were initially explored by multivariate analysis using a logistic regression model. A forward stepwise procedure was used to select model terms, including only those who made a signi cant contribution to the model (P < 0.05). Power calculations A large study was conducted to allow relatively small differences to be detected. The power of the study was speci cally calculated on the assumption that 1050 subjects would receive a questionnaire, with a 70% response rate (735 responses). The study had 90% power to detect a 10% difference between the proportion of subjects reporting good or complete relief of symptoms from ibuprofen compared to other NSAIDs. In practice because of a high response rate the study was somewhat more powerful than intended. RESULTS Patients studied A total of 1137 questionnaires were sent out; 947 patients replied (response rate 83%); of these 928 met the age criteria (18±80 years) of the study and provided analysable information. The average age of the respondents was 59.3 years (mean s.d. 15.8). Drug choice Ibuprofen (31.7%), diclofenac (31.8%) and naproxen (22.2%) accounted for 85.7% of prescriptions, with indomethacin (4.8%), piroxicam (3.0%), ketoprofen (1.6%) and benorylate (1.1%), being the only other drugs to be prescribed to more than 1% of patients. The prescribed average daily dose of ibuprofen, diclofenac and naproxen was mg, mg and mg, respectively (Table 1). Additional NSAIDs (other than the index drug) were prescribed to 6.8% of patients (including aspirin for cardiovascular prophylaxis in 3.8%). Factors in uencing prescription of ibuprofen Table 2 shows the factors associated with prescription of ibuprofen. The main factor in uencing the choice of ibuprofen was the individual practice (P < ), with one practice using ibuprofen for 1.0% of its prescriptions and another using it for 69.1% (compared to an overall average of 31.7%). Indication for use, number of other medications and age were also signi cant in uences, but sex, past history of ulcer disease and co-prescription of ulcer drugs were not. There was no obvious relationship to practice size,

3 IBUPROFEN VS. OTHER NSAIDS 189 Table 1. Drug exposure Ibuprofen n = 281 Diclofenac n = 294 Napraoxen n = 215 Mean daily dose In mg (s.d.) (314) (32) (254) Mean number of de ned daily doses prescribed 1.41 (0.39) 1.55 (0.43) 1.61 (0.51) per day (s.d.) Mean compliance rate (s.d.) (0.55) (0.56) (0.55) Number of de ned daily dose units received 1.02 (0.88) 1.19 (0.87) 1.25 (1.05) per day (s.d.) Length of prescription in days (s.d.) (13.0) (10.6) (13.2) location, deprivation index or prescribing burden that explained the difference in rates of ibuprofen prescribing between the practices under study. Ibuprofen was less likely to be used in in ammatory arthritis and in patients receiving multiple other drugs. Patients receiving ibuprofen tended to report severe or very severe pretreatment pain somewhat less frequently than those receiving other drugs (Table 3). The relationship of ibuprofen use to age was complex (Table 2). The odds ratio for ibuprofen choice, adjusted for other factors in the model, was higher in older than in younger patients. However, actual use was lower in the elderly because these patients were less likely to have conditions associated with high ibuprofen usage. Exposure There was no signi cant difference in the prescription length for the three main drugs prescribed (Table 1). Compliance for each of the three drugs was similar. Patients who were prescribed ibuprofen were generally prescribed a low daily dose ( mg). Effectiveness of ibuprofen compared to other NSAIDs Table 4 shows that 49.4% of patients reported good or complete relief, with no signi cant differences between individual NSAIDs (P > 0.2). Ibuprofen tended to be used in patients with a lower pre-treatment severity. However, when patients were strati ed for initial severity, the proportion reporting good or complete relief still did not vary signi cantly between the individual NSAIDs (P > 0.2). Similarly, if the analysis was restricted to those with in ammatory arthritis the amount of reported relief did not differ signi cantly between individual NSAIDs (P > 0.2). In the logistic regression analysis, symptom relief was not signi cantly in uenced by the initial diagnosis or severity, age, sex, practice or mode of usage (regularly vs. as required). Adverse drug experiences Fewer patients taking ibuprofen reported adverse effects compared to patients taking diclofenac and naproxen (an average of 0.49, 0.57 and 0.57 side-effects were reported per patient, respectively) although the Table 2. Factors associated with choice of ibuprofen Variable P-value Ibuprofen % prescriptions Odds ratio (95% CI) Practice Practice % 1* Practice (1.9±6.3) Practice 3 1.0% 0.01 (0.002±0.05) Indication In ammatory arthritis 21.5% 1* Osteoarthritis 27.9% 1.1 (0.6±2.0) Other musculoskeletal 33.9% 2.4 (1.4±4.2) Miscellaneous 44.3% 3.2 (1.5±7.1) Number of < % 1* other drugs % 0.5 (0.3±0.7) Age group ± % 1* 45± % 1.41 (0.87±2.27) 65± % 2.56 (1.42±4.55) * Reference category. Some non-signi cant pair-wise comparisons are omitted for clarity.

4 190 C. J. HAWKEY et al. Table 3. Severity of initial condition according to drug choice Overall Ibuprofen Diclofenac Naproxen Other % using 100% 31.7% 31.8% 22.2% 14.3% Condition described as very severe/severe pre-treatment 61.2% 55.5% 62.9% 61.6% 68.6% Unable to dress unaided pre-treatment 8.5% 7.0% 10.8% 8.0% 6.9% Able to do normal work/housework pre-treatment 23.2% 28.5% 20.7% 21.8% 12.0% Unable to climb stairs unaided pre-treatment 39.7% 34.1% 42.1% 39.8% 46.9% Table 4. Drug effectiveness & tolerability Overall Ibuprofen Diclofenac Naproxen Other Condition severe/very severe pre treatment 62.9% 56.6% 66.4% 63.0% 67.4% post treatment 36.0% 31.9% 36.2% 36.2% 43.5% Good/complete relief 49.4% 52.7% 49.0% 44.9% 50.7% If condition initially severe/very severe 46.5% 50.0% 45.7% 41.2% 51.7% If used for in ammatory arthritis 56.3% 40.0% 46.7% 56.0% 73.1% Best treatment 50.5% 50.3% 50.5% 50.3% 51.5% Side-effects 54.9% 49.0% 58.2% 56.6% 56.9% GI side-effects 36.0% 31.1% 39.5% 36.2% 37.7% Upper GI side-effects 22.5% 18.7% 24.7% 25.0% 20.8% difference was not statistically signi cant (v 2 - test ˆ 2.428, P ˆ 0.119). No speci c pattern was associated with any of the individual NSAIDs. Overall NSAID satisfaction Approval for different NSAIDs was very similar with 50.3% rating ibuprofen as the best treatment recieved, vs. 50.5% for diclofenac, 50.3% for naproxen and 51.5% for other NSAIDs. Drug costs The average drug cost of an NSAID prescription, at the frequencies used in this study was 5.97 per prescription, varying from 2.29 for ibuprofen to for diclofenac. Based on an annualized rate derived from the 3 months prior to the index prescription, patients in the study received 5.92 prescriptions per annum. In the patients studied, if ibuprofen use rose from 31.7% to 50% (and overall NSAID use remained the same), drug costs would fall by 16.5%. If half of non-ibuprofen NSAID users were switched to ibuprofen drug, costs would fall by 30.9%. Drugs costs would fall by 61.5% if all patients were switched to ibuprofen at the dosage used in this study. DISCUSSION Although the level of ibuprofen prescribing varied greatly from practice to practice, patients receiving ibuprofen appeared to experience similar levels of relief and to value it to the same extent as patients prescribed diclofenac and naproxen, regardless of practice, age, sex, indication for use, mode of usage (regular vs. `as required') or severity of underlying condition. Although the patients we studied were, to some extent, a population selected by satisfaction with their current treatment, it seems likely that more patients than at present could use ibuprofen. Using ibuprofen in favour of other NSAIDs would have direct economic consequences since ibuprofen at the doses used by the practices in this study costs less than all other commonly used NSAIDs, with the exception of generic indomethacin. In the patients studied, if ibuprofen use rose from 31.7% to 50% (and overall NSAID use remained the same), drug costs would fall by 16.5%. If half of non-ibuprofen NSAID users were switched to ibuprofen, drug costs would fall by 30.9%. For the calendar year 1998, in England, there were 18.3 million prescriptions for NSAIDs at a total cost of million. 6 A reduction of 30.9% would represent a saving of approximately 48.7 million.

5 IBUPROFEN VS. OTHER NSAIDS 191 Indirect savings may also accrue from ibuprofen usage because of its lower toxicity. Symptomatically ibuprofen was somewhat better tolerated by our patients than other NSAIDs but these differences did not reach signi cance and the potential savings that could accrue from any reduction in current levels of co-prescription of anti-ulcer drugs that might occur would be relatively limited. More important are the reductions in costs, morbidity and mortality arising from the now well recognized lower risk of ulcer complications for ibuprofen compared to other NSAIDs. It has been suggested that ibuprofen is less likely to cause gastrointestinal complications because it is prescribed at relatively low doses. 4 Although ibuprofen was used at a relative low mean daily dose in our study, patients receiving ibuprofen appeared to experience similar levels of relief and to value it to the same extent as other NSAIDs. Low NSAID doses may achieve genuine therapeutic selectivity. Whilst several studies have shown a relentless and linear rise in the incidence of ulcer complications with increasing NSAID doses, there is evidence that the analgesic bene ts of NSAIDs are achieved at relatively low doses. 7 Our study does suggest that considerable savings, both economic and medical could be made by switching as many NSAID users as possible to ibuprofen, and we are presently undertaking studies to test this proposition directly. We thank the general practitioners, their practice managers, receptionists and nurses who helped with data collection, the patients for providing the primary data, Dr Sarah Smith for help with statistical analysis, and Miss Donna Hall and Mrs Rosemary Dainty for typing the manuscript. REFERENCES 1 Hawkey CJ, Hudson N. Mucosal injury induced by drugs, chemicals and stress. In: Haubrich W, Snaffer F, eds. Bockus Gastroenterology, 5th edn. Philadelphia: WB Saunders, Garcia Rodriguez LA, Jick H. Risk of upper gastrointestinal bleeding and perforation associated with individual non steroidal anti in ammatory drugs. Lancet 1994; 343: 769±73. 3 Langman MJS, Weil J, Wainwright P, et al. Risks of bleeding peptic ulcer associated with individual non steroidal anti in ammatory drugs. Lancet 1994; 343: 1075±8. 4 Henry D, Lim LL-Y, Garcia Rodriguez LA, et al. Variability in risk of gastrointestinal complications with individual non-steroidal anti-in ammatory drugs: results of a collaborative metaanalysis. Br Med J 1996; 312: 1563±6. 5 WHO Collaborating Centre For Drug Statistics Methodology. Anatomical Therapeutic Chemical Classi cation Index. Oslo: WHO Collaborating Centre for Drug Statistics Methodology, Roberts D. Prescribing Support Unit, Leeds. Personal Communication, Gotzsche PC. Review of dose±response studies of NSAIDs in rheumatoid arthritis. Dan Med Bull 1989; 36: 395±9. ACKNOWLEDGEMENTS This study was funded by Trent Locally Organized Research Fund.

Gastrointestinal Tolerability of Ibuprofen Compared with Paracetamol and Aspirin at Over-the-counter Doses

Gastrointestinal Tolerability of Ibuprofen Compared with Paracetamol and Aspirin at Over-the-counter Doses The Journal of International Medical Research 2002; 30: 301 308 Gastrointestinal Tolerability of Ibuprofen Compared with Paracetamol and Aspirin at Over-the-counter Doses P RAMPAL 1, N MOORE 2, E VAN GANSE

More information

Non-steroidal anti-inflammatory drugs: who should receive prophylaxis?

Non-steroidal anti-inflammatory drugs: who should receive prophylaxis? Aliment Pharmacol Ther 2004; 20 (Suppl. 2): 59 64. Non-steroidal anti-inflammatory drugs: who should receive prophylaxis? C. J. HAWKEY Wolfson Digestive Diseases Centre, Institute of Clinical Research,

More information

PIRPROFEN IN TREATMENT OF NON-ARTICULAR RHEUMATISM IN PAKISTANI OUTPATIENTS, A MULTICENTRE STUDY

PIRPROFEN IN TREATMENT OF NON-ARTICULAR RHEUMATISM IN PAKISTANI OUTPATIENTS, A MULTICENTRE STUDY Abstract PIRPROFEN IN TREATMENT OF NON-ARTICULAR RHEUMATISM IN PAKISTANI OUTPATIENTS, A MULTICENTRE STUDY Pages with reference to book, From 265 To 268 N,A.Jaffer ( Ciba-Geigy (Pakistan) Limited, Karachi.

More information

Original Article. Abstract. Introduction

Original Article. Abstract. Introduction Original Article Frequency of NSAID Induced Peptic Ulcer Disease Saeed Hamid, Javed Yakoob, Wasim Jafri, Shanul Islam, Shahab Abid, Muhammad Islam Section of Gastroenterology, Department of Medicine, Aga

More information

Which peptic ulcer patients bleed?

Which peptic ulcer patients bleed? Gut, 1988, 29, 70-74 Which peptic ulcer patients bleed? K MATTHEWSON, S PUGH, AND T C NORTHFIELD From the Gastroenterology Units, St James Hospital, Balham and University College Hospital, London SUMMARY

More information

NSAIDs Overview. Souraya Domiati, Pharm D, MS

NSAIDs Overview. Souraya Domiati, Pharm D, MS NSAIDs Overview Souraya Domiati, Pharm D, MS Case A 32 years old shows up into your pharmacy asking for an NSAID for his ankle pain He smokes1 pack/day His BP is 125/75mmHg His BMI is 35kg/m2 His is on

More information

AN NSAID WITH A BALANCED COX-1 & COX-2 INHIBITORY EFFECT

AN NSAID WITH A BALANCED COX-1 & COX-2 INHIBITORY EFFECT AN NSAID WITH A BALANCED COX-1 & COX-2 INHIBITORY EFFECT A balanced cox-1 and cox-2 inhibitor Metabolisim and Bioavailabillty of Lornoxicam (3) Relative selectivity of agents as inhibitors of cox-1 and

More information

Community Pharmacy Dispensing Practice. by Pharmacists and Pharmacy Assistants in Manila City

Community Pharmacy Dispensing Practice. by Pharmacists and Pharmacy Assistants in Manila City Community Pharmacy Dispensing Practice of Non-steroidal Anti inflammatory drugs by Pharmacists and Pharmacy Assistants in Manila City De Los Santos, S.K.M.; Go, J.K.C.; Hung, K.S.; Medina, I.C.L.; Ong,

More information

patient group direction

patient group direction NAPROXEN v01 1/10 NAPROXEN PGD Details Version 1.0 Legal category Staff grades Approved by POM Paramedic (Non-ECP) Nurse (Non-ECP) Emergency Care Practitioner (Paramedic) Emergency Care Practitioner (Nurse)

More information

NSAIDs. NSAIDs are important but they can have side effects.

NSAIDs. NSAIDs are important but they can have side effects. NSAIDs Pain Treatment Nonsteroidal anti-inflammatory drugs (NSAIDs) are often recommended for initial treatment of pain and can be added to more powerful drugs to treat worse pain. Acetaminophen, such

More information

Nonsteroidal anti-inflammatory drugs (NSAIDs) are

Nonsteroidal anti-inflammatory drugs (NSAIDs) are CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2013;11:499 504 Failure to Renew Prescriptions for Gastroprotective Agents to Patients on Continuous Nonsteroidal Anti-inflammatory Drugs Increases Rate of Upper

More information

The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 9 January 2013

The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 9 January 2013 The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 9 January 2013 The opinion adopted by the Transparency Committee on 4 July 2012 was given a hearing on 5 December

More information

Proceedings of the First Hong Kong (Asia PacFfic) Medical Informatics Conference

Proceedings of the First Hong Kong (Asia PacFfic) Medical Informatics Conference HK Proceedings of the First Hong Kong (Asia PacFfic) Medical Informatics Conference Hong Kong Polytechnid 6-18 November 1990 Edited by ANTHONY J HEDLEY Department of Community Medicine University of Hong

More information

Etoricoxib STADA 30 mg, 60 mg, 90 mg and 120 mg film-coated tablets , Version V1.2 PUBLIC SUMMARY OF THE RISK MANAGEMENT PLAN

Etoricoxib STADA 30 mg, 60 mg, 90 mg and 120 mg film-coated tablets , Version V1.2 PUBLIC SUMMARY OF THE RISK MANAGEMENT PLAN Etoricoxib STADA 30 mg, 60 mg, 90 mg and 120 mg film-coated tablets 23.5.2016, Version V1.2 PUBLIC SUMMARY OF THE RISK MANAGEMENT PLAN VI.2 Elements for a Public Summary Etoricoxib STADA 30 mg film-coated

More information

Epidemiologic Evidence on the Association Between Peptic Ulceration and Antiinflammatory Drug Use

Epidemiologic Evidence on the Association Between Peptic Ulceration and Antiinflammatory Drug Use GASTROENTEROLOGY 1989;96:640-6 Epidemiologic Evidence on the Association Between Peptic Ulceration and Antiinflammatory Drug Use M. J. S. LANGMAN Department of Medicine, Queen Elizabeth Hospital, Birmingham,

More information

British Medical Journal. June 3, 2006;332: Patricia M Kearney, Colin Baigent, Jon Godwin, Heather Halls, Jonathan R Emberson, Carlo Patrono

British Medical Journal. June 3, 2006;332: Patricia M Kearney, Colin Baigent, Jon Godwin, Heather Halls, Jonathan R Emberson, Carlo Patrono Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Metaanalysis of randomised trials 1 British Medical Journal June 3,

More information

Therapy with NSAIDS. Prepared by

Therapy with NSAIDS. Prepared by Therapy with NSAIDS coxibs aspirin & Prepared by Prof. Terry Bolin MD(NSW), BS(Syd), FRACP, FRCP(Lond), FRCP(Edin), DCH(Lond) Associate Professor of Medicine, University of NSW. Gastrointestinal and Liver

More information

What Is Peptic Ulcer Disease?

What Is Peptic Ulcer Disease? What Is Peptic Ulcer Disease? Peptic ulcer disease is when painful sores form in the lining of the stomach, duodenum (start of the small intestine) or bowels. An ulcer can cause belly pain and, in some

More information

Adolescents' use of prescribed drugs and over-the-counter preparations

Adolescents' use of prescribed drugs and over-the-counter preparations Journal of Public Health Medicine Vol. 18, No. 4, pp. 437-442 Printed in Great Britain Adolescents' use of prescribed drugs and over-the-counter preparations Regina Dengler and Heather Roberts Abstract

More information

Opinion 23 July 2014

Opinion 23 July 2014 The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 23 July 2014 IMUREL 50 mg, film-coated tablet (B/100) (CIP: 34009 364 149 0 7) IMUREL 25 mg, film-coated tablet (B/50)

More information

ALZHEIMER'S DRUGS. Details. Step 2: Exelon Patch 13.3 mg/24 hour transdermal Exelon Patch 4.6 mg/24 hr transdermal

ALZHEIMER'S DRUGS. Details. Step 2: Exelon Patch 13.3 mg/24 hour transdermal Exelon Patch 4.6 mg/24 hr transdermal ALZHEIMER'S DRUGS Products Affected Step 1: donepezil 10 mg disintegrating tablet donepezil 10 mg tablet donepezil 23 mg tablet donepezil 5 mg disintegrating tablet donepezil 5 mg tablet galantamine 12

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. EASOFEN MAX STRENGTH 400mg FILM-COATED TABLETS. Ibuprofen

PACKAGE LEAFLET: INFORMATION FOR THE USER. EASOFEN MAX STRENGTH 400mg FILM-COATED TABLETS. Ibuprofen PACKAGE LEAFLET: INFORMATION FOR THE USER EASOFEN MAX STRENGTH 400mg FILM-COATED TABLETS Ibuprofen Read all of this leaflet carefully before you start taking Easofen Max Strength Tablets because it contains

More information

Evidence-based medicine: data mining and pharmacoepidemiology research

Evidence-based medicine: data mining and pharmacoepidemiology research Data Mining VII: Data, Text and Web Mining and their Business Applications 307 Evidence-based medicine: data mining and pharmacoepidemiology research B. B. Little 1,2,3, R. A. Weideman 3, K. C. Kelly 3

More information

NSAID Use in Post- Myocardial Infarction Patients. Leah Jackson, BScPhm Pharmacy Resident Cardiology Rotation February 28, 2007

NSAID Use in Post- Myocardial Infarction Patients. Leah Jackson, BScPhm Pharmacy Resident Cardiology Rotation February 28, 2007 NSAID Use in Post- Myocardial Infarction Patients Leah Jackson, BScPhm Pharmacy Resident Cardiology Rotation February 28, 2007 Objectives By the end of the presentation, the audience will be able to use

More information

The prevalence and history of knee osteoarthritis in general practice: a case control study

The prevalence and history of knee osteoarthritis in general practice: a case control study The Author (2005). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org doi:10.1093/fampra/cmh700 Family Practice Advance Access

More information

Can i take ibuprofen with lansoprazole

Can i take ibuprofen with lansoprazole P ford residence southampton, ny Can i take ibuprofen with lansoprazole Lansoprazole 15mg & 30mg Gastro-resistant Capsules - Patient Information Leaflet (PIL) by Zentiva. Quick over the counter viagra

More information

Non-steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal Anti-Inflammatory Drugs (NSAIDs) Non-steroidal Anti-Inflammatory Drugs (NSAIDs) 110465 NSAIDs.indd 1 9/16/16 10:18 AM About your medicine NSAIDs are pain medications used to relieve your pain and inflammation (e.g. swelling, redness and

More information

Review Article. Safety Profile of Nonsteroidal Antiflammatory Drugs (NSAID) Safety Profile of NSAID

Review Article. Safety Profile of Nonsteroidal Antiflammatory Drugs (NSAID) Safety Profile of NSAID Safety Profile of Nonsteroidal Antiflammatory Drugs (NSAID) R. Stoilov: University Hospital St Ivan Rilski, Clinic of Rheumatology Contact: Rumen Stoilov, Clinic of Rheumatology, University Hospital St

More information

Health Economics 101: PPI prescriptions in the Emergency Room

Health Economics 101: PPI prescriptions in the Emergency Room : PPI prescriptions in the Emergency Room Canadian Optimal Medication Prescribing & Utilization Service (COMPUS) Presented by: Chris Cameron October 26, 2007 What is Health Economics? Health economics

More information

Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs?

Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs? Aliment Pharmacol Ther 2003; 18: 973 978. doi: 10.1046/j.0269-2813.2003.01798.x Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs? S.

More information

NSAIDs: The Truth About Cardiovascular Risk

NSAIDs: The Truth About Cardiovascular Risk NSAIDs: The Truth About Cardiovascular Risk Adam Grunbaum DO FACOI FACR American College of Osteopathic Internists Annual Convention and Scientific Sessions October 3 rd 2015 Disclosures none 2 Objectives

More information

TRANSPARENCY COMMITTEE OPINION. 26 November 2008

TRANSPARENCY COMMITTEE OPINION. 26 November 2008 The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 26 November 2008 CHONDROSULF 400 mg, capsule Box containing 84 capsules (CIP: 335 917-3) CHONDROSULF 400 mg, granules

More information

NON STEROIDEAL ANTI-INFLAMMATORY DRUGS AND CARDIOVASCULAR RISK. Advances in Cardiac Arrhythmias and Great Innovations in Cardiology

NON STEROIDEAL ANTI-INFLAMMATORY DRUGS AND CARDIOVASCULAR RISK. Advances in Cardiac Arrhythmias and Great Innovations in Cardiology NON STEROIDEAL ANTI-INFLAMMATORY DRUGS AND CARDIOVASCULAR RISK Advances in Cardiac Arrhythmias and Great Innovations in Cardiology Torino, October 15, 2016 Giuseppe Di Pasquale Direttore Dipartimento Medico

More information

PEPTIC ULCER IN RHEUMATOID ARTHRITIS- INTRINSIC OR RELATED TO DRUG THERAPY?

PEPTIC ULCER IN RHEUMATOID ARTHRITIS- INTRINSIC OR RELATED TO DRUG THERAPY? British Journal of Rheumatology 1986;25:342-344 PEPTIC ULCER IN RHEUMATOID ARTHRITIS- INTRIIC OR RELATED TO DRUG THERAPY? BY D. E. MALONE, P. A. McCORMICK, L. DALY, B. JONES, A. LONG, B. BRESNIHAN, J.

More information

A comparison of Ketoprofen and Diclofenac for acute musculoskeletal pain relief: a prospective randomised clinical trial

A comparison of Ketoprofen and Diclofenac for acute musculoskeletal pain relief: a prospective randomised clinical trial Hong Kong Journal of Emergency Medicine A comparison of Ketoprofen and Diclofenac for acute musculoskeletal pain relief: a prospective randomised clinical trial P Ng, CW Kam, HH Yau Objectives: To compare

More information

Guide to Understanding and Managing Arthritis

Guide to Understanding and Managing Arthritis Guide to Understanding and Managing Arthritis The content in this guide is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician

More information

Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case control analysis

Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case control analysis 752 CARDIOVASCULAR MEDICINE Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case control analysis J Hippisley-Cox, C Coupland... Heart

More information

New Medicine Review. Racecadotril for the symptomatic treatment of acute diarrhoea (adults and children over 3 months)

New Medicine Review. Racecadotril for the symptomatic treatment of acute diarrhoea (adults and children over 3 months) BEDFORDSHIRE AND LUTON JOINT PRESCRIBING COMMITTEE (JPC) April 2013 Review date: April 2016 Bulletin 180: Racecadotril for the symptomatic treatment of acute diarrhoea in adults and children over 3 months

More information

TERICOX. Composition Each film-coated tablet contains 60, 90, or 120 mg of Etoricoxib.

TERICOX. Composition Each film-coated tablet contains 60, 90, or 120 mg of Etoricoxib. TERICOX Composition Each film-coated tablet contains 60, 90, or 120 mg of Etoricoxib. Tablets Action Tericox is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic,

More information

HAQ-II(Health Assessment Questionnaire-II)

HAQ-II(Health Assessment Questionnaire-II) Kathy Karamlou, MD 355 Placentia Ave, suite 208 Newport Beach, CA 92663 949-631-6500 949-631-9700 NAME: DATE: DOB: HAQ-II(Health Assessment Questionnaire-II) We are interested in learning how your illness

More information

Use of NSAIDs and infection with Helicobacter pylori what does the rheumatologist need to know?

Use of NSAIDs and infection with Helicobacter pylori what does the rheumatologist need to know? Rheumatology 2008;47:1342 1347 Advance Access publication 13 May 2008 doi:10.1093/rheumatology/ken123 Use of NSAIDs and infection with Helicobacter pylori what does the rheumatologist need to know? U.

More information

Managing Osteoarthritis Pain With Medicines. A Review of the Research for Adults

Managing Osteoarthritis Pain With Medicines. A Review of the Research for Adults Managing Osteoarthritis Pain With Medicines A Review of the Research for Adults Is This Summary Right for Me? Yes, if: A doctor* said you have osteoarthritis (pronounced ah-stee-oharth-rye-tis). Osteoarthritis

More information

There s A Pill For That (But should my patient be on it?) A Review of Tools for the Evaluation of Optimal Prescribing in Geriatric Patients

There s A Pill For That (But should my patient be on it?) A Review of Tools for the Evaluation of Optimal Prescribing in Geriatric Patients There s A Pill For That (But should my patient be on it?) A Review of Tools for the Evaluation of Optimal Prescribing in Geriatric Patients Marilyn N. Bulloch, PharmD, BCPS Assistant Clinical Professor

More information

Pharmacoeconomic Modeling of Prior-Authorization Intervention for COX-2 Specific Inhibitors in a 3-Tier Copay Plan

Pharmacoeconomic Modeling of Prior-Authorization Intervention for COX-2 Specific Inhibitors in a 3-Tier Copay Plan ORIGINAL RESEARCH Pharmacoeconomic Modeling of Prior-Authorization Intervention for COX-2 Specific Inhibitors in a 3-Tier Copay Plan JANE STACY, PharmD; ELIZABETH SHAW, MSIE; MICHELE D. ARLEDGE, PharmD;

More information

Guide to the Modernized Reference Drug Program

Guide to the Modernized Reference Drug Program Guide to the Modernized Reference Drug Program For prescribers and pharmacists Medical Beneficiary and Pharmaceutical Services Division June 1, 2016 Contents 1 Introduction 1 2 About this Guide 2 3 About

More information

Efficacy of esomeprazole for resolution of symptoms of heartburn and acid regurgitation in continuous users of non-steroidal anti-inflammatory drugs

Efficacy of esomeprazole for resolution of symptoms of heartburn and acid regurgitation in continuous users of non-steroidal anti-inflammatory drugs Alimentary Pharmacology & Therapeutics Efficacy of esomeprazole for resolution of symptoms of heartburn and acid regurgitation in continuous users of non-steroidal anti-inflammatory drugs C. J. HAWKEY*,

More information

Analgesic Subcommittee of PTAC Meeting held 1 March 2016

Analgesic Subcommittee of PTAC Meeting held 1 March 2016 Analgesic Subcommittee of PTAC Meeting held 1 March 2016 (minutes for web publishing) The Analgesic Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology and

More information

Methods to develop arthritis and osteoporosis measures: a view from the National Committee for Quality Assurance (NCQA)

Methods to develop arthritis and osteoporosis measures: a view from the National Committee for Quality Assurance (NCQA) Methods to develop arthritis and osteoporosis measures: a view from the National Committee for Quality Assurance (NCQA) S.L. Sampsel, C.H. MacLean 1, L.G. Pawlson, S. Hudson Scholle National Committee

More information

Lack of adherence to lipid-lowering drug treatment. A comparison of utilization patterns in de ned populations in Funen, Denmark and Bologna, Italy

Lack of adherence to lipid-lowering drug treatment. A comparison of utilization patterns in de ned populations in Funen, Denmark and Bologna, Italy Lack of adherence to lipid-lowering drug treatment. A comparison of utilization patterns in de ned populations in Funen, Denmark and Bologna, Italy John Larsen, 1,2 Alberto Vaccheri, 3 Morten Andersen,

More information

Guidance for Pharmacists on Safe Supply of Oral Methotrexate

Guidance for Pharmacists on Safe Supply of Oral Methotrexate Guidance for Pharmacists on Safe Supply of Oral Methotrexate Pharmaceutical Society of Ireland Version 2 January 2015 Contents 1. Introduction 2 2. Methotrexate 2 3. Guidance 2 3.1 Patient Review 2 3.2

More information

Is Ginger Effective in Reducing Knee Pain in Adults With Osteoarthritis?

Is Ginger Effective in Reducing Knee Pain in Adults With Osteoarthritis? Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2015 Is Ginger Effective in Reducing Knee

More information

Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs

Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs ORIGINAL ARTICLE Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs Yuki Sakamoto, Tadashi Shimoyama, Satoru Nakagawa,

More information

Smoking and Smoking Cessation in England 2011: Findings from the Smoking Toolkit Study

Smoking and Smoking Cessation in England 2011: Findings from the Smoking Toolkit Study Smoking and Smoking Cessation in England 211: Findings from the Smoking Toolkit Study Robert West and Jamie Brown Cancer Research UK Health Behaviour Research Centre University College London robert.west@ucl.ac.uk

More information

- Description, Objectives, Operational Framework

- Description, Objectives, Operational Framework 2 1. CNCD - Overview (significance, causes, burden) 2. CDAP - Description, Objectives, Operational Framework 3. Research Findings of Study on CDAP - Research Objectives and Methodology - Limitations and

More information

Prevalence of psychosomatic and other medical illnesses in anorexic and bulimic patients 1

Prevalence of psychosomatic and other medical illnesses in anorexic and bulimic patients 1 Behavioural Neurology (1993),6, 123-127 Prevalence of psychosomatic and other medical illnesses in anorexic and bulimic patients 1 A.-M. Ghadirian, F. Engelsmann, P. Leichner and M. Marshall Department

More information

Evaluating framing e ects

Evaluating framing e ects Journal of Economic Psychology 22 2001) 91±101 www.elsevier.com/locate/joep Evaluating framing e ects James N. Druckman * Department of Political Science, University of Minnesota, 1414 Social Sciences

More information

Nonsteroidal Anti-inflammatory Drugs and the Incidence of Hospitalizations for Peptic Ulcer Disease in Elderly Persons

Nonsteroidal Anti-inflammatory Drugs and the Incidence of Hospitalizations for Peptic Ulcer Disease in Elderly Persons American Journal of Epidemiology Copyright C 1995 by The Johns Hopkins University School of Hygiene and Public Health All rights reserved Vol. 141, No. 6 Printed In USA. Nonsteroidal Anti-inflammatory

More information

No Association between Calcium Channel Blocker Use and Confirmed Bleeding Peptic Ulcer Disease

No Association between Calcium Channel Blocker Use and Confirmed Bleeding Peptic Ulcer Disease American Journal of Epidemiology Copyright 1998 by The Johns Hopkins University School of Hygiene and Public Health All rights reserved Vol. 148, No. 4 Printed in U.S.A. A BRIEF ORIGINAL CONTRIBUTION No

More information

5. Current Activities

5. Current Activities 5. Current Activities 5. Current Activities The following discussion suggests only some of the kinds of activities and resources that can contribute to postmarketing surveillance. The Food and Drug Administration

More information

NSAIDs and tissue healing - bone. Sigbjørn Dimmen and Lars Engebretsen, Orthopaedic Center, Ullevaal University Hospital, Oslo, Norway

NSAIDs and tissue healing - bone. Sigbjørn Dimmen and Lars Engebretsen, Orthopaedic Center, Ullevaal University Hospital, Oslo, Norway NSAIDs and tissue healing - bone. Sigbjørn Dimmen and Lars Engebretsen, Orthopaedic Center, Ullevaal University Hospital, Oslo, Norway Prevalence of use of NSAIDs in sport Most used drug class in Olympic

More information

PrEP in Scotland. PrEP. in Scotland. PrEP. PrEP. PrEP. PrEP is a combination pill that prevents HIV.

PrEP in Scotland. PrEP. in Scotland. PrEP. PrEP. PrEP. PrEP is a combination pill that prevents HIV. PrEP in Scotland PrEP PrEP PrEP PrEP is a combination pill that prevents HIV. 1 Contents Introduction 3 What is PrEP 3 Who should take PrEP 4 Getting PrEP in Scotland 5 Side effects and interactions with

More information

UNIVERSITY STATEMENT FOR STUDENTS ON SUBSTANCE USE/MISUSE

UNIVERSITY STATEMENT FOR STUDENTS ON SUBSTANCE USE/MISUSE UNIVERSITY STATEMENT FOR STUDENTS ON SUBSTANCE USE/MISUSE HEALTH & SAFETY UNIT AUTUMN 2012 CONTENTS 1 AIM... 2 2 APPLICATION... 2 3 DEFINITIONS... 2 4 EDUCATION AND AWARENESS RAISING... 2 5 PROVISION OF

More information

Hip, n (%) Left Right Left Right Left Right Left Right Left Right 81 (21.2) 87 (22.8) 79 (20.7)

Hip, n (%) Left Right Left Right Left Right Left Right Left Right 81 (21.2) 87 (22.8) 79 (20.7) FLEXISEQ : An innovative treatment for the management of pain and stiffness in patients with osteoarthritis: Real-life data from a patient survey of members of the Feierabend Community Abstract FLEXISEQ

More information

Original Article Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal

Original Article Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal Kathmandu University Medical Journal (2006), Vol. 4, No. 2, Issue 14, Original Article Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal Shankar

More information

Anneloes van Walsem 1, Shaloo Pandhi 2, Richard M Nixon 2, Patricia Guyot 1, Andreas Karabis 1* and R Andrew Moore 3

Anneloes van Walsem 1, Shaloo Pandhi 2, Richard M Nixon 2, Patricia Guyot 1, Andreas Karabis 1* and R Andrew Moore 3 van Walsem et al. Arthritis Research & Therapy (2015) 17:66 DOI 10.1186/s13075-015-0554-0 RESEARCH ARTICLE Open Access Relative benefit-risk comparing diclofenac to other traditional non-steroidal anti-inflammatory

More information

Products available Methotrexate tablets 2.5mg ONLY (Methotrexate tablets 10mg are NOT recommended as per NPSA guidance 5 ).

Products available Methotrexate tablets 2.5mg ONLY (Methotrexate tablets 10mg are NOT recommended as per NPSA guidance 5 ). Methotrexate Traffic light classification- Amber 1 Information sheet for Primary Care Prescribers Part of the Shared Care Protocol: Management of Rheumatological Conditions with Disease-Modifying Anti

More information

NHS England Getting Serious About Prevention

NHS England Getting Serious About Prevention NHS England Getting Serious About Prevention Dr Matt Kearney GP and National Clinical Director for Cardiovascular Disease Prevention NHS England and Public Health England The NHS needs a radical upgrade

More information

ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6

ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6 ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6 HYPERLIPIDEMIA Cholesterol Total cholesterol LDL cholesterol HDL cholesterol men women Triglycerides

More information

Single dose oral analgesics for acute postoperative pain in adults (Review)

Single dose oral analgesics for acute postoperative pain in adults (Review) Single dose oral analgesics for acute postoperative pain in adults (Review) Moore RA, Derry S, McQuay HJ, Wiffen PJ This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration

More information

Introduction. JW Moul 1,2, RM Mooneyhan 2, T-C Kao 3, DG McLeod 1,2 and DF Cruess 3

Introduction. JW Moul 1,2, RM Mooneyhan 2, T-C Kao 3, DG McLeod 1,2 and DF Cruess 3 Prostate Cancer and Prostatic Diseases (1998) 5, 242±249 ß 1998 Stockton Press All rights reserved 1365±7852/98 $12.00 http://www.stockton-press.co.uk/pcan Preoperative and operative factors to predict

More information

Osteoporosis: fragility fracture risk. Costing report. Implementing NICE guidance

Osteoporosis: fragility fracture risk. Costing report. Implementing NICE guidance Osteoporosis: fragility fracture risk Costing report Implementing NICE guidance August 2012 NICE clinical guideline 146 1 of 15 This costing report accompanies the clinical guideline: Osteoporosis: assessing

More information

Guidelines for controlled trials of drugs in migraine: second edition

Guidelines for controlled trials of drugs in migraine: second edition Guidelines for controlled trials of drugs in migraine: second edition International Headache Society Clinical Trials Subcommittee. Committee members: P Tfelt-Hansen (Chairman) (Denmark), G Block (USA),

More information

NSAID-Induced Gastrointestinal Damage

NSAID-Induced Gastrointestinal Damage GASTROENTEROLOGY BOARD REVIEW MANUAL STATEMENT OF EDITORIAL PURPOSE The Hospital Physician Gastroenterology Board Review Manual is a study guide for fellows and practicing physicians preparing for board

More information

Clinical Policy: Goserelin Acetate (Zoladex) Reference Number: ERX.SPA.145 Effective Date:

Clinical Policy: Goserelin Acetate (Zoladex) Reference Number: ERX.SPA.145 Effective Date: Clinical Policy: (Zoladex) Reference Number: ERX.SPA.145 Effective Date: 10.01.16 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal

More information

Prescription Opioids: The Real Story 4/30/15

Prescription Opioids: The Real Story 4/30/15 Prescription Opioids: The Real Story 4/30/15 Don Teater MD Medical Advisor National Safety Council Masters student at the UNC Gillings School of Global Public Health Don Teater MD Disclaimer: The information

More information

Pain Management The Orthopaedic Surgeon s Perspective

Pain Management The Orthopaedic Surgeon s Perspective November 2007 Highlights Report: Pain Management The Orthopaedic Surgeon s Perspective This Highlights Report offers an overview of Pain Management The Orthopaedic Surgeon s Perspective by Harry N. Herkowitz,

More information

EMILOK Global. (omeprazole) Composition: Each capsule contains 20 mg omeprazole as enteric-coated

EMILOK Global. (omeprazole) Composition: Each capsule contains 20 mg omeprazole as enteric-coated EMILOK Global (omeprazole) Composition: Each capsule contains 20 mg omeprazole as enteric-coated granules. Properties: Emilok (omeprazole) belongs to the group of proton pump inhibitors, inhibits both

More information

CHAPTER 3 RESEARCH METHODOLOGY

CHAPTER 3 RESEARCH METHODOLOGY CHAPTER 3 RESEARCH METHODOLOGY 3.1 Introduction 3.1 Methodology 3.1.1 Research Design 3.1. Research Framework Design 3.1.3 Research Instrument 3.1.4 Validity of Questionnaire 3.1.5 Statistical Measurement

More information

Predicting compliance with annual follow-up evaluations in persons with spinal cord injury

Predicting compliance with annual follow-up evaluations in persons with spinal cord injury Spinal Cord (199) 35, 314 ± 319 199 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/9 $12.00 Predicting compliance with annual follow-up evaluations in persons with spinal cord

More information

Title: Socioeconomic conditions and number of pain sites in women

Title: Socioeconomic conditions and number of pain sites in women Author's response to reviews Title: Socioeconomic conditions and number of pain sites in women Authors: Finn E Skjeldestad (fisk@fhi.no) Toril Rannestad (Toril.Rannestad@hist.no) Version: 2 Date: 17 January

More information

Allina Health Weight Management Weight Loss Surgery Online Post-test

Allina Health Weight Management Weight Loss Surgery Online Post-test Allina Health Weight Management Weight Loss Surgery Online Post-test Name PRINT SAVE AS E-MAIL RESET Today s Date Email Address: This post-test is to be completed after viewing the on-line Informational

More information

Measuring Quality in Arthritis Care: The Arthritis Foundation s Quality Indicator Set for Analgesics

Measuring Quality in Arthritis Care: The Arthritis Foundation s Quality Indicator Set for Analgesics Arthritis & Rheumatism (Arthritis Care & Research) Vol. 51, No. 3, June 15, 2004, pp 337 349 DOI 10.1002/art.20422 2004, American College of Rheumatology ORIGINAL ARTICLE Measuring Quality in Arthritis

More information

Nonsteroidal anti-inflammatory drugs are among the

Nonsteroidal anti-inflammatory drugs are among the GASTROENTEROLOGY 2007;133:790 798 Risk of Peptic Ulcer Hospitalizations in Users of NSAIDs With Gastroprotective Cotherapy Versus Coxibs WAYNE A. RAY,*, CECILIA P. CHUNG, C. MICHAEL STEIN,, WALTER E. SMALLEY,,

More information

HARVARD PILGRIM HEALTH CARE RECOMMENDED MEDICATION REQUEST GUIDELINES HUMIRA PEDIATRIC

HARVARD PILGRIM HEALTH CARE RECOMMENDED MEDICATION REQUEST GUIDELINES HUMIRA PEDIATRIC Generic Brand HICL GCN Exception/Other ADALIMUMAB HUMIRA 24800 HUMIRA PEDIATRIC GUIDELINES FOR USE INITIAL CRITERIA (NOTE: FOR RENEWAL CRITERIA SEE BELOW) 1. Is the patient currently taking Humira? If

More information

Duodenal Ulcer / Duodenitis

Duodenal Ulcer / Duodenitis Duodenal Ulcer / Duodenitis Endoscopy Department Patient information leaflet You will only be given this leaflet if you have been diagnosed with duodenitis and/or a duodenal ulcer. The information below

More information

Promotion of Self Care Briefing Document

Promotion of Self Care Briefing Document RCCG/GB/17/035 Promotion of Self Care Briefing Document 1. Introduction The proposal aims to promote self-care through the purchasing of medications and products from local pharmacies for the treatment

More information

Product Cost per Pack Cost per 28 days (assuming 2 sprays od) Flixonase years 50mcg in both nostrils od (increasing to max bd prn)

Product Cost per Pack Cost per 28 days (assuming 2 sprays od) Flixonase years 50mcg in both nostrils od (increasing to max bd prn) Protocol for Flixonase to Avamys Nasal Spray Switch May 2010 1. Reason Avamys contains the corticosteroid fluticasone furoate (27.5mcg/spray) and Flixonase nasal spray contains fluticasone propionate (50mcg/spray).

More information

How to use PRECIS-2 - Designing trials that are fit for purpose

How to use PRECIS-2 - Designing trials that are fit for purpose PRECIS-2 toolkit We would be very grateful if users would give us feedback on using PRECIS-2: just click on Contact us. These PRECIS-2 criteria are constantly being reviewed and we welcome your input.

More information

ASPIRIN AND VASCULAR DISEASE

ASPIRIN AND VASCULAR DISEASE ASPIRIN AND VASCULAR DISEASE SUMMARY Aspirin is an effective antiplatelet agent for patients with cardiovascular and cerebrovascular disease. Incidence of adverse effects and drug interactions increases

More information

NSAIDS - non-salicylates

NSAIDS - non-salicylates NSAIDS - non-salicylates Sandra P. Welch, Ph.D. Professor Pharmacology & Toxicology McGuire Hall Room 505, 828-8424, swelch@hsc.vcu.edu Learning Objectives: 1. Learn the main differentiating property,

More information

Designing an Electronic Medical Record-based Clinical Decision Support Tool to Improve CVD Screening in Rheumatoid Arthritis Patients

Designing an Electronic Medical Record-based Clinical Decision Support Tool to Improve CVD Screening in Rheumatoid Arthritis Patients Designing an Electronic Medical Record-based Clinical Decision Support Tool to Improve CVD Screening in Rheumatoid Arthritis Patients Provided and Certified By Grant Award # 045604 Report Date: March 29,

More information

DBA Design Effectiveness Awards SoloSTAR. A disposable pen injector for insulin

DBA Design Effectiveness Awards SoloSTAR. A disposable pen injector for insulin DBA Design Effectiveness Awards 2009 SoloSTAR A disposable pen injector for insulin Category: Sub category: Client company: Design consultancy: Product Consumer Sanofi Aventis GmbH DCA Design International

More information

The legally binding text is the original French version

The legally binding text is the original French version The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 3 January 2007 DICLOFENAC SODIUM MIKA PHARMA 4%, skin spray solution 7.5 g Vial (CIP: 362 261-8) 12.5 g Vial (CIP:

More information

Condition: Pain management

Condition: Pain management Condition: Pain management Description: In general, over-the-counter (OTC) pain medication or topical ophthalmic drugs (such as cyclopentolate) will be sufficient to ease discomfort in patients under the

More information

The effectiveness of omeprazole, clarithromycin and tinidazole in eradicating Helicobacter pylori in a community screen and treat programme

The effectiveness of omeprazole, clarithromycin and tinidazole in eradicating Helicobacter pylori in a community screen and treat programme Aliment Pharmacol Ther 2000; 14: 719±728. The effectiveness of omeprazole, clarithromycin and tinidazole in eradicating Helicobacter pylori in a community screen and treat programme P. MOAYYEDI*, R. FELTBOWER,

More information

Prescribing of high-dose and combination antipsychotics on adult acute and intensive care wards: Clinical introduction, methodology and glossary.

Prescribing of high-dose and combination antipsychotics on adult acute and intensive care wards: Clinical introduction, methodology and glossary. POMH-UK Topic 1 report 1b Prescribing of high-dose and combination antipsychotics on adult : Clinical introduction, methodology and glossary. March 2007 Prepared by the Prescribing Observatory for Mental

More information

Number of records submitted: 14,750 Number of participants: Part 1 = 146 hospitals (120 trusts); Part 2 = 140 hospitals (119 trusts)

Number of records submitted: 14,750 Number of participants: Part 1 = 146 hospitals (120 trusts); Part 2 = 140 hospitals (119 trusts) British Thoracic Society Smoking Cessation Audit Report Smoking cessation policy and practice in NHS hospitals National Audit Period: 1 April 31 May 2016 Dr Sanjay Agrawal and Dr Zaheer Mangera Number

More information

The in uence of attitudes on personal computer utilization among knowledge workers: the case of Saudi Arabia

The in uence of attitudes on personal computer utilization among knowledge workers: the case of Saudi Arabia Information & Management 36 (1999) 185±204 Research The in uence of attitudes on personal computer utilization among knowledge workers: the case of Saudi Arabia Muhammad A. Al-Khaldi *, R.S. Olusegun Wallace

More information

TOFACITINIB PATIENT INFORMATION ON. (Brand name: Xeljanz ) What is tofacitinib? Important things to remember

TOFACITINIB PATIENT INFORMATION ON. (Brand name: Xeljanz ) What is tofacitinib? Important things to remember PATIENT INFORMATION ON TOFACITINIB (Brand name: Xeljanz ) This information sheet has been produced by the Australian Rheumatology Association to help you understand the medicine that has been prescribed

More information